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Avaliação da sensibilidade in vitro de agentes causadores de cromoblastomicose frente a diferentes antifúngicos, isolados e associados / In vitro susceptibility assessment of agents of the chromoblastomycosis againts different antifungals, isolated and combination (association)

O objetivo do presente trabalho foi estudar a ação de diversos antifúngicos isolados e associados a anfotericina B contra amostras sequenciais ou não recuperadas de pacientes com cromoblastomicose e submetidas ou não a tratamento. A partir de 18 pacientes foram isoladas 39 cepas, submetidas a testes de diluição em ágar contendo anfotericina B, cetoconazol, itraconazol, terbinafina, 5-fluorocitosina, fluconazol ou griseofulvina. Com base nas CIMs e nas concentrações séricas desses antifúngicos verificou-se que as amostras foram, de modo geral, sensíveis ao cetoconazol, a terbinafina e ao itraconazol. Somente 13 amostras foram sensíveis a anfotericina, 7 a 5-FC, 2 ao fluconazol e nenhuma à griseofulvina.Com relação as CFMs, 2 cepas foram sensíveis a AnB, 11 ao itraconazol, 20 ao cetoconazol e 3 a 5-FC. Seis não responderam a terbinafina e 38 ao fluconazol. As combinações de antifúngicos resultaram em interações principalmente aditivas ou indiferentes. O estudo de isolados seqüenciais evidenciou um ponto de corte para sensibilidade desses agentes ao itraconazol, correspondente a ClMs ≤0,06µg/ml desse azol. / The aim of the present work was to study the action of several antifungals isolated and combined with amphotericin B against sequential or non-sequential samples in patients infected with chromoblastomycosis and treated or not treated. Thirty nine strains from 18 patients were isolated and submitted to agar dilution testing containing amphotericin B, cetoconazole, itraconazole, terbinafine, 5-flucytosin, fluconazole or griseofulvin. Based on the CIMs and on the serum levels of these antifungals, the isolates were susceptible to ketoconazole, terbinafine and itraconazole. Only 13 of the isolates were susceptible to amphotericin; seven to 5-FC, two to fluconazole and none to a griseofulvin. Regarding the CFMs two strains were susceptible to AnB, 11 for itraconazole, 20 for ketoconazole and three for 5-FC. Six didn\'t respond to terbinafine and 38 for fluconazole. The combination of antifungals resulted in mainly additive or indifferent interaction. The study of the sequential isolated sample showed a breaking point for the susceptibility of these agents to itraconazole, corresponding CIMs ≤0,06µg/ml of this azole.

Identiferoai:union.ndltd.org:IBICT/oai:teses.usp.br:tde-16062009-093300
Date29 September 2003
CreatorsViviane Mazo Fávero Gimenes
ContributorsArlete Emily Cury, Sandro Rogério de Almeida, Maria Walderez Szeszs
PublisherUniversidade de São Paulo, Farmácia (Análise Clínicas), USP, BR
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Sourcereponame:Biblioteca Digital de Teses e Dissertações da USP, instname:Universidade de São Paulo, instacron:USP
Rightsinfo:eu-repo/semantics/openAccess

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